The top 10 mistakes dental practices make

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In my travels around the United States and in conversations with dentists and dental team members, the thing that perhaps surprises me the most is how the dental practice is seen as just that … a dental practice. Rarely is it actually looked upon as what it truly is: a small business. 

When the practice begins being viewed by the entire team as a small business, amazing things happen. Suddenly, dental team members understand the correlation between the success of the business and their paycheck. They suddenly see every day as not just an opportunity to improve the lives of their patients, but also as an opportunity to make a difference in “the company.”

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This is just one of the things that I see as a common practice management mistake in most dental practices. In my 15 years of working in the dental publishing field, I’ve talked to a lot of dentists and team members about what is and isn’t working in the practice. I’ve listened and learned and turned a lot of those thoughts and comments into the meat of this article. So, without further delay, let’s look at the 10 biggest practice management mistakes that most dental practices make, as well as how those mistakes can be eliminated.

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Not treating your team correctly

 I see this way too often in way too many dental practices. While the dentist is absolutely “the boss” of the practice, it is the team (both front and back office) that makes the practice run. It’s also the team that has the closest relationship with the patients. When patients make an appointment or pay the bill, they talk to Mary at the front desk. Mary is also the last person they see before they leave the practice, meaning she’s the first and last impression for every patient. Your hygienist, Cindy, spends 10 times longer with an average patient during a recall appointment than the dentist. The assistant, Jennifer, is the one your patient turns to after you leave the room to ask if a new crown is really necessary.

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Without your team members as truly a part of “your team,” your practice is going to struggle. Think about this … where do you spend the majority of your time awake during the week? Is it with your family? No, it’s at your job. Why not do everything you can to ensure your practice is a place you (and your team members) actually want to go each day?

I once asked dental assistants to tell me the nicest and meanest thing a dentist ever said to them. Of course, you can imagine some of the meanest things that I have heard (one assistant was called “dog meat” in front of a patient while another was told in front of a patient that a spider monkey could do her job … and do it better). There were many “mean” answers, but there was one answer that was the overwhelming favorite as the nicest thing a dentist ever said to them. It was simple but made an impact. It was “thank you.”

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Yes, those two words that we so often take for granted as part of human interaction has made a lasting impact to countless dental assistants around the country. When was the last time you said “thank you” to a member of your team?

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Not treating your practice as a small business

Your dental practice is a small business. Have you ever really thought about it that way? Your practice is in the same category as the florist and mom-and-pop café down the street. If you don’t treat your practice as a small business, it’s going to suffer.

I understand completely that you went to dental school to be a dentist and not a businessperson. However, creating beautiful smiles and actually having the patient pay for his or her smile are interconnected. Without those patients coming through the door, you can’t create their smile ... so how are you drawing patients through your doors? Is it through social media? Is it through advertising? Is it through local marketing? What is the “secret sauce” that pulls patients into your practice?

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Of course, once they get through the doors and arrange to have those beautiful smiles, how do you make sure you are getting the money for those procedures? What’s the best route for your practice? Is it taking insurance or is it operating as a fee-for-service practice? Are you going to offer CareCredit as a payment possibility for your patients?

Yes, these are a lot of questions, but these questions build the foundation for the type of practice you really want to have. If you’re trying to create a boutique, upscale, cosmetic dentistry-centered practice, you don’t want PPOs dominating your finances.

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Take a few moments this week and look at your “business plan” for your practice. What does it consist of … or does it even exist? Sit down with your team and make sure the vision you have for the practice is the same way that they are communicating over the phone and in person to patients. If your thoughts don’t match up to their actions, you’re going to struggle to create the practice you envisioned when you left dental school.

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Not using social media correctly

 I was speaking at a dental meeting recently and talking about the importance of social media to a practice’s success. A dentist raised his hand and told me, “All my front office girl does is play on Facebook all day.” Many dentists in the audience nodded their heads in agreement.

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After the meeting, I looked at the dentist’s Facebook page and was pleasantly surprised to see that it was a page that was constantly updated with pictures of young children smiling after seeing the dentist (and getting that special sticker of course) as well as teens who had just had their braces removed. What the dentist envisioned as “playing on Facebook” was actually his front desk person trying to establish a social media presence for the practice.

I know of a lot of dentists who believe it’s enough to put up a website and the patients will come running through the front doors. However, that’s not the case in today’s world, where not only do you have a website, but so do 25 other dentists within a 10-mile radius of you.

How do you stand out? My good friend Rita Zamora, an expert on social media in the dental practice, will tell you that your website has to be constantly updated. You don’t want stock photos of people smiling by the lake when you’re in the middle of Iowa farm country with no lakes nearby. Make sure you’re getting testimonials and before-and-after photos from your patients (with their permission, of course) and letting other patients see the difference your practice can make in “one of their own.”

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You’ll hear a lot about SEO today and that is important, so make sure you’re reaching out to an expert in dental social media like Rita to help your practice succeed and jump ahead of your peers. When someone uses Google to find a dentist in Jackson, Miss. (or whatever city you’re in), you want them to find you, so take a few minutes and talk to an expert about how SEO can help your practice.

Also, set up a time to talk to your team about how social media can and should be used by your practice. I can almost guarantee that you have one member of your team who can make an impact on Facebook or Twitter for your practice. Let that person “run with the ball” and monitor the progress on a weekly basis. If something isn’t reaching the audience you want, sit down with an expert to get some advice.

One word of caution (we’ll talk a little more about this in the next point as well) … an “expert” in dental social media isn’t your 15-year-old nephew who uses Facebook to talk about his day at school or favorite NFL team. Pay a little bit of money to someone who knows social media AND knows dentistry. Let that person get you started down the right path and plant the seeds, then let your dedicated team member take over and cultivate the garden.

Related reading: Managing social media for the dental practice

Remember, social media is about being “social.” It isn’t just you telling the world you’re having a special on whitening this month. It’s about snapping photos of patients who have taken advantage of the whitening special and posting the before-and-after photos on your site. We learn a lot from our peers and when we see our friends and neighbors improving their smile, it makes a bigger impact than a dentist telling me his or her practice is having a special this month.

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Not having a training budget

It’s crazy to me to hear how much a dentist will pay for a new laser or CAD/CAM system, but won’t invest the extra money into training for the entire team. There’s nothing wrong with buying something based on a dental recommendation or what you saw on the show floor, but you have to make sure you are really getting your money’s worth for what you bought. Otherwise, in about six months, you’re going to have a really expensive piece of equipment collecting dust in the corner (and your team members aren’t going to be happy about the investment and lack of return).

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A perfect example is annual training for practice management software. There are new features constantly being added to your software that could make a big difference in finances and time savings for your practice, yet practices will go years in between software training sessions. In that time span, let’s say you’ve had some turnover in the front office, so you’re now having someone train someone on the software that she was trained on by someone else. How much knowledge do you think is really passed down? Do you think it’s a wide range or do you think it’s just the very basics that helped her predecessor get the job done? My guess is the latter.

Dr. John Flucke, technology editor and chief dental editor for Dental Products Report, is a dentist in suburban Kansas City, Mo. He is also an avid believer in the importance of annual software training for the entire team, including himself.

“It’s worth every penny to me,” Flucke said. “Yeah, it costs a little extra but I know I am getting a tremendous return on investment for what I spend. Practice management software is what runs my business from the front to the back. At the end of the day, I know my team has the skills and knowledge to make that software run at the top level for my practice. Honestly, that’s a lot of peace of mind for me.”

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Again, it goes far beyond just software in your practice. When is the last time you did any training on your technology? Make sure every member of your team has the “latest and greatest” information. When they do, you know your systems and technology will be running at full capacity.

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Making your patients uncomfortable in your practice

You know it. I know it. We all know it. The dentist’s office isn’t most people’s favorite place in the world. You are already aware of that, so now you have to ensure you are doing everything possible to make the visit as comfortable as possible.

It starts in the waiting room. Is your front desk person warm and friendly or cold and grouchy? If you can’t answer “warm and friendly” with 100 percent confidence, then it’s time for some skills training. As I mentioned earlier, your front desk person is the first and last impression for your patients. Do you want them to have a positive or negative experience?

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Also in the waiting room, aside from the person at the front desk, is it a comfortable experience? When is the last time you sat in your own waiting room for 10 minutes? Are the chairs comfortable? Are the magazines readable? Is the décor dated? If you were walking into an office and this is what you saw, what would you think? Be honest with yourself when you’re sitting there and looking around. If you have any hesitations, it’s time for some changes.

When you’re done sitting in the waiting room, step outside and look at the exterior of your office. How does it look? Does it need a new paint job? Are the flowers alive or still dead from that early frost three months ago? If you’re establishing yourself as a cosmetic dentist, but your practice looks like it’s falling apart, do you think your patients will put much faith in your dental abilities?

The final thing to check out is your operatory. When is the last time you updated your décor in there? Again, does it scream “modern and comfortable” or “aged and outdated?” Hey, if you’re going for a 1980s themed office, that’s great. Just make sure you have the theme from “Miami Vice” on constant loop on your Walkman-powered sound system.

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It goes back to a point I made earlier with technology. Yes, it’s going to cost a little extra money to freshen up your practice, but you have to look at the overall picture. You’ll have something to talk about with your patients on social media. You’ll have some new pictures to put on your website. For those patients who have been loyal customers, they can see the updates and be impressed.

Talk to your dealer. See what ideas he or she has and then don’t be afraid to act upon them.

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Allowing your team members to have ugly smiles

During my lectures around the country, I’ve seen hygienists and assistants who have smiles that aren’t the most attractive. That is nothing against them personally (hey, I’m in the dental publications business and had crooked teeth until my Six Month Smiles treatment at the age of 44) but these men and women are ambassadors for your practice. If I’m a patient sitting in your chair and I see your team members (or you) without straight, white teeth, I’m going to have some second and third thoughts about investing my money into your practice for a cosmetic procedure.

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If a team member has a less-than-attractive smile (and wants to change that!), invest your own time and resources into fixing their smile. I’m not talking about a full mouth reconstruction here. I’m talking about some simple, quick procedures that can make a difference and turn an OK smile into one that can help you show your skills.

Also, the before-and-after photos of your team members’ transformed smiles will be great for your website and for social media. It reaffirms the belief that there is trust and it’s a great talking point for your team when they are chatting with your patients about a procedure. If your team members trust you enough with the smiles, your patients should as well.

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Not having your entire team attend CE courses

If the dentist is the only one who is furthering his or her education, it means that the team is being left behind. How can you train on a procedure and then expect your assistant to immediately know what he or she should do?

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Make sure that you are attending courses that are geared toward the entire team. It provides for a great opportunity to get together outside of the practice and is a chance for the team to grow in their skills and knowledge.

Imagine coming back from a dental implant course and telling your team how you’re going to start working this into your practice mix. Of course, you’re excited … but is your team? Many thoughts could be wandering through their minds, including, “Yeah, we heard this about that laser course six months ago and look what happened.”

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Now imagine coming back from that same dental implant course with the entire team excited about what the new procedure can do for the practice. You can talk about it to a patient. The assistant can help that patient know exactly what to expect in terms of comfort level and recovery time. The front desk can know exactly what insurance can be filed and how it can be billed. Everyone is on the same page, and that makes the patient much more confident in accepting treatment.

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Not attending yearly dental trade shows 

As I type this, I flash back to riding on a train toward Cologne, Germany, to attend the International Dental Show (IDS). Held every two years, the IDS is the mecca of dental meetings. What makes it different? There is no continuing education given. IDS is five days filled with walking the trade show floor, learning about the latest new products and seeing the latest techniques delivered live via learning centers. It’s truly an amazing experience.

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Am I saying you and your team should attend IDS? I do believe everyone should at least once in his or her life, as it is such a different experience than attending a dental meeting in the United States. However, there are a lot of other options much closer to home for you and your team.

The important thing about attending a dental meeting is that everyone attends courses that are of interest to them and their skill sets, and then reports back on Monday about what they learned and how it can be implemented into the practice’s daily routine. It’s not only about attending the course, but it’s also about learning from the course and seeing how the new knowledge can be used on a daily basis.

This learning will also take some trust on the part of the dentist. Your team members could come back from this meeting excited about what they’ve learned … so are you willing to listen to their suggestions or will you be unwilling to change? I’ve talked to countless dental assistants in my lectures that have told me, “I’d love to try that, but my dentist will never change.” Are you one of the dentists who fit that description? If so, trust me, your team knows it and is frustrated by it. They’re ready to spread their wings and try new things to improve the practice. Are you?

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Attending a dental trade show with your entire team and talking about what was learned is the perfect opportunity to see if you’re ready to take that next step and expand your practice. Not every idea is a great idea … but not every idea is a bad idea either. Listen to your team. Learn from them. Move forward together and watch your practice grow.

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Not being willing to change

There’s the old story about the frog and the boiling pot of water. If you throw a frog into the boiling pot of water, he’ll jump right back out and save himself. However, if you put a frog in a pot of water and slow warm it to the boiling point, he’ll boil right along with the water. The point is that he doesn’t see something is changing around him until it’s too late.

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I know a lot of dental practices are like that as well. They don’t want to change because everything is comfortable and fine, and then one day they blink and realize the world has changed around them. Other practices in the area are using new technology or are using new ways to market to potential patients. Trust me, I get that change is uncomfortable and it’s a lot easier to do nothing than take a chance on something.

However, doing nothing is often not the best thing for business. Talk to your rep. Read dental publications. Talk to your colleagues. What’s new and exciting out there that you might like to try (and would be good to boost your business)? If the team is on board and the move is right for business, change can be a wonderful and motivating thing for everyone in your practice.

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Not being transparent with your team about your numbers

 I have heard from dentists time and time again that the dental practice is their livelihood and their investment and they don’t want anyone else knowing how well (or not so well) they’re doing. Of all the mistakes we’ve discussed so far, this could be the most damaging.

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When your team doesn’t know how the practice is doing financially, they’re not in a position to help when things aren’t going well or in a position to celebrate with you when a goal is achieved. Your team will also view your lack of sharing as a lack of trust in them. Absolutely, as a dentist, the practice is your livelihood, but it’s also the livelihood of your team members as well. They depend on their job to feed their families and get their kids through school just like you do. If something isn’t going well in the practice, it affects all of your families, not just yours.

Dentists have told me often that they don’t want to share the numbers with their team because it might open the conversations about raises. That’s absolutely true. However, if you’re paying your team a good salary (you can check for the latest hourly and annual salary figures for dentists, hygienists, and assistants from around the nation) and you’re treating them well, it’s an easy conversation to have. By starting conversations with all of the cards on the table, it makes it easier to have a team that is fully invested in the success of your business. After all, when the business succeeds, everyone succeeds.

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There you have it. The 10 biggest mistakes that I see dental practices/small businesses making way, way too often. What has resonated with you from this article? Are there other mistakes you’d like to add to the list? I’d love to hear your thoughts and feedback. Drop me a line at

In the meantime, here’s to making 2016 the best year ever for you, your team, and your business.